“Breast is best”—Infant-feeding, infant mortality and infant welfare in Germany during the late nineteenth and twentieth centuries

Abstract

Breastfeeding is considered to be the key variable for infant health. Consequently, UNICEF and the World Health Organization promote the beginning of breastfeeding within the first hour after birth and recommend to exclusively breastfeed the infant during the first six months. The origins of these modern breastfeeding campaigns can be traced back to the beginning of the twentieth century. Whereas high infant mortality rates traditionally were considered to be a matter of fate and the declining birth rates towards the end of the nineteenth century raised fears about the nation's future and led to the emergence of an increasing infant welfare movement in imperial Germany. As low breastfeeding rates were identified as a key factor behind the high infant mortality rates, the main objective of the infant care movement was to increase breastfeeding. The paper examines how the context of infant care and infant mortality was constructed and how breastfeeding campaigns in the context of infant mortality, breastfeeding rates and socio-political changes developed during the twentieth century. Thus the paper covers the period from the beginnings of social paediatrics at the beginning of the 20th century, the breastfeeding campaigns embedded into Nazi ideology during the Third Reich, until the declining breastfeeding ratios and the "feeding on demand"-movement in the 1970s as well as the ideological differences between West and East Germany during the Cold War.

Adalbert Czerny (1863–1941) and his contribution to the fight against infant mortality

“…Between 1820-1890, the German infant mortality rate exceeded 300 per 1000 live births a number of times. 4 However, it declined from 244 per 1000 live births in 1871-1875 to 63 in 1936-1939. 5 Infant nutrition during the 1870 s included being breastfed by the child's mother or a wet nurse and feeding bottles.…”

“…Czerny's career coincided with a highly impressive period of medical achievements in Germany, which culminated in major reductions in child morbidity and mortality. Between 1820–1890, the German infant mortality rate exceeded 300 per 1000 live births a number of times 4 . However, it declined from 244 per 1000 live births in 1871–1875 to 63 in 1936–1939 5 .…”

The Ethics of Ancient Lactation and the Cult of the Perfect Breastfeeding Mother

“…Breastfeeding is a key issue found in ancient sources that resonates with public debates about babies' right to mother's milk, maternal ideology and mothers' mental health that affect women today in different parts of the world and from all walks of life [1][2][3][4][5][6]. This article discusses the idea of the perfect breastfeeding mother in ancient and contemporary health discourses and parenting models by reflecting upon breastfeeding as a socially determined requisite for good mothering.…”

“…Therefore, by critically analysing ancient medical and philosophical narratives on breastfeeding from the 1st to the 6th century CE, this article poses a primary question: were non-breastfeeding mothers considered "bad mothers" in antiquity? Accordingly, it examines (1) what happened when a mother could not or chose not to breastfeed her baby in antiquity; and (2) whether ancient theory, practice and culture diverged on the ethics of lactation.…”

“…However, a holistic overview of the phenomenon "breastfeeding" from antiquity to the present day is beyond the scope of the present paper. Our research aims to provide a focused perspective on the ethical issues of breastfeeding in terms of: (1) timeframe: the 1st to 6th century CE; (2) objective: difficult and discriminatory experiences of breastfeeding; (3) subjective perception: looking at the experience of breastfeeding from the mother's point of view; and (4) objective perception: reflecting the clash between the mother's self-perception of her body and experience of breastfeeding and that of the society. By investigating the relationship between the new mother's agency and her environment in a historical perspective, the article shows that historically: (1) ethical issues revolving around maternal and new-born health belong to the cultural contexts of health and wellbeing, and (2) new mothers are often caught up between the social acceptance of breastfeeding as a virtue, medical normativity, their own postpartum body and mental health [5,30,35], [37] (p. 243), [14] (p. 120), [38] (p. 79), [39,40].…”